Thank you !

Thank you for your reply. Appreciated It is never too late for me to receive your reply. At least I learn something from your reply.

Yes, we have got the viral load test result, and it is undetectable, thank God.

Now, I just hope for the CD4 to continue increase, as I understand that there were cases whereby undetectable viral load with LOW CD4. Only with higher CD4, then there will be lesser percentage on opportunistic infections. Doctor, can you tell me, when all the symptoms of the TB is under controlled, is that means the CD4 will continue to increase? But I told myself not to be too demanding.

Can I raise another question? My husband is now in his 4th month TB treatment. The latest lung X-ray shows opacity is resolving. His body temperature also remains at 37 degree Celsius to 37.2 degree Celsius. Gain around 2kg weight lately. Doctor therefore reduced his TB medicine, and he is to take this medicine combination for another 5 to 8 months, although my husband is still having very little phlegm early in the morning. Do you think there will be any problem in the medicine adjustment? Will it be too early to reduce the medicine, since he took about 2 months before the body temperature was being reduced from 37.5 degree Celsius to 37.2 degree Celsius?

Thank you for always sharing your expertise. I do hope my husband can survive for longest possible. He was making a mistake by getting the virus, as a wife, I never get angry with him as I feel sad seeing him regret. I do hope the God is having the same feeling as me, FORGIVE dont penalize him by taking his life away, please think of his wife, and his baby especially.

Sorry but thanks for allowing me to release my feeling.

Warmest Regards,

Response from Dr. Young

Thanks for your follow up.

I'm very happy to hear that your husband's viral load is undetectable. Yes, it's not uncommon to see CD4 cell responses to be delayed, especially in the face of active (or on treatment) tuberculosis.

As for his TB treatment, many treatment protocols use a reduction in the number of medications (from 4 to 3, for example) after the first months of sucessful treatment-- your question about his prolonged fever is interesting, though I don't think this need change the timing of the treatment adjustment. Indeed, with his clearing chest Xray, I think that we can surmise with some confidence that things are improving.

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